...HOUSTON Oct. 30 2008 While a growing number of doctors are introduc...The team will be led by Amalia M. Issa who heads the Program in Perso...Issa's project will analyze the willingness of patients from various s... Personalized medicine lies at the crossroads of science and technolo...

HOUSTON, Oct. 30, 2008 While a growing number of doctors are introducing personalized medicine into their practices, it remains largely unclear how receptive patients are to employing genomic diagnostics to tailor-make drugs. Armed with a $398,000, two-year grant, a University of Houston research team has initiated a research project to determine patient preferences and, thus, educate health policymakers and physicians.

The team will be led by Amalia M. Issa, who heads the Program in Personalized Medicine and Targeted Therapeutics at the Abramson Family Center for the Future of Health, a joint initiative between UH and The Methodist Hospital Research Institute. Personalized medicine uses a genotype or gene expression profile to stratify patients into smaller sub-populations to achieve greater prescribing precision, Issa explained. It can be used to identify disease stages, the most appropriate medications or dosages, or even preventative measures.

Issa's project will analyze the willingness of patients from various socio-economic backgrounds to adopt, and pay for the use of, genomic diagnostics to tailor prescriptions.

"Personalized medicine lies at the crossroads of science and technology, and there are a number of barriers to its translation and implementation into clinical practice," said Issa, associate professor at the UH College of Technology and College of Pharmacy. "As the science and technology advance, we need to be able to understand how personalized medicine applications will be accepted and adopted by patients. After all, it is patients who will help shape how the different technologies are used and which populations use them."

According to the Centers for Disease Control and Prevention in Atlanta, genetic tests for more than 1,200 diseases have been developed. Genetic testing initially was used largely to diagnose rare genetic disorders and determine ancestry, but an increasing number have broader applications, such as carrier identification, inherited risk prediction and drug-response assessment.

The UH research team aims to identify what types of trade-offs patients are willing to make when opting for pharmacogenomic testing, which uses genomic information to determine whether a drug is likely to cause beneficial or negative reactions. For instance, Issa said, patients considering pharmacogenomic testing must weigh out such things as the cost of the procedure and whether or not they want their genetic information on file with their insurance companies.

"As a field, personalized medicine includes diagnostic and therapeutic interventions, with risk defined through genetics as well as environmental factors," said Issa. "We believe it is important to quantify the attributes and trade-offs that patients encounter in order to predict demand and utilization of these emerging applications so that better health policies can be developed to maximize benefits and minimize risks."

The team expects its findings will lead to a better understanding of what technologies are currently in use, how they are incorporated into medical practice, which populations have access to them, and how the patient decision-making process works.

Yuen-Sum "Vincent" Lau, chair of the College of Pharmacy's pharmacological and pharmaceutical sciences department, emphasized that "Dr. Issa and her team are conducting a cutting-edge translational research, which will make the findings from basic and clinical research applicable to real medical practices and lead to better health-care delivery in the future."

The award announced last week by the Institute for Health Technology Studies (InHealth) was part of a $1.7 million package in grants for scientists examining the economic and social impacts of diagnostic and therapeutic medical devices on treating diseases and chronic medical conditions. InHealth gathers evidence about the contributions of technology to patients and society and makes the results available to policymakers and health leaders.

"Health issues reduce the quality of life for millions of Americans while incurring a heavy economic burden on patients and the health-care system," said Martyn Howgill, executive director of InHealth. "Medical technology plays a pivotal role in the diagnosis and treatment of injury and disease and while the intuitive evidence clearly suggests that medical technology benefits the patient, there's little objective evidence of its value to policymakers and regulators."

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